Nilsson Olga, Stenman Malin, Letterstål Anna, Hultgren Rebecka
Department of Molecular Medicine and Surgery, Stockholm Aortic Research Group, STAR, Karolinska Institutet, Stockholm, Sweden.
Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden.
BJS Open. 2024 Dec 30;9(1). doi: 10.1093/bjsopen/zrae144.
The longitudinal effects of educational interventions in people with abdominal aortic aneurysm are largely unexplored. This prospective study investigated whether the anxiety-lowering effect of an eHealth intervention observed at the 1-month follow-up is maintained 1 year after abdominal aortic aneurysm surgery.
Those scheduled for surgical repair of abdominal aortic aneurysm were recruited in a single-centre randomized clinical trial. The control group received care and follow-up per the institution's standard. The intervention group received an eHealth tool along with psychosocial support. The 1-month results have been reported. The primary outcome measure was the anxiety mean score (HADS-A).
Of 120 included participants, 96 completed the 1-year follow-up (48 in each treatment group). The mean age was 73 years, a majority (86%) were male and 73% were current or previous smokers. Anxiety symptoms measured with the HADS-A decreased over time in both the intervention group (-0.33) and the control group (-0.35, P = 0.868). The improvements in anxiety symptoms seen in the short-term follow-up were not sustained at the 1-year follow-up. No significant mean score differences were found in the intention-to-treat or per-protocol analyses.
In this randomized clinical trial, an eHealth intervention did not result in a sustained reduction in anxiety symptoms compared with standard care in the same cohort. The study provides an insight into the limited acceptability of an eHealth tool in people with abdominal aortic aneurysm and valuable data on the recovery trajectory following open and endovascular abdominal aortic aneurysm surgery. Further research is warranted to evaluate the relevance and long-term effectiveness of eHealth interventions in abdominal aortic aneurysm care.
NCT03157973 (http://www.clinicaltrials.gov).
教育干预对腹主动脉瘤患者的长期影响在很大程度上尚未得到探索。这项前瞻性研究调查了在1个月随访时观察到的电子健康干预降低焦虑的效果在腹主动脉瘤手术后1年是否依然存在。
在一项单中心随机临床试验中招募计划接受腹主动脉瘤手术修复的患者。对照组按照机构标准接受护理和随访。干预组除了接受心理社会支持外,还使用了一种电子健康工具。1个月的结果已经报告。主要结局指标是焦虑平均评分(医院焦虑抑郁量表-焦虑分量表,HADS-A)。
纳入的120名参与者中,96人完成了1年随访(每个治疗组48人)。平均年龄为73岁,大多数(86%)为男性,73%为当前吸烟者或既往吸烟者。干预组(-0.33)和对照组(-0.35,P = 0.868)使用HADS-A测量的焦虑症状均随时间下降。短期随访中观察到的焦虑症状改善在1年随访时未持续。在意向性分析或符合方案分析中均未发现显著的平均评分差异。
在这项随机临床试验中,与同一队列中的标准护理相比,电子健康干预并未导致焦虑症状持续减轻。该研究揭示了电子健康工具在腹主动脉瘤患者中的可接受性有限,并提供了关于开放性和血管腔内腹主动脉瘤手术后恢复轨迹的宝贵数据。有必要进一步研究以评估电子健康干预在腹主动脉瘤护理中的相关性和长期有效性。
NCT03157973(http://www.clinicaltrials.gov)